Well lets start with a common diagnosis in pregnancy SPD & PGP...
What is SPD & PGP..?
Symphysis pubis dysfunction (SPD), or pelvic girdle pain (PGP), happens when the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy soon before birth (as delivery nears, things are supposed to start loosening up).
This, in turn, can make the pelvic joint — aka the symphysis pubis — unstable, causing some pretty strange sensations, including pelvic pain.
How do I get relief from pelvic pain in pregnancy?
This is the million dollar question. You may not get complete relief until after the birth. I had it during my last pregnancy from around 19 weeks, and the relief just after giving birth was immense. You may still experience some discomfort postnatally, but the weight of the baby and imbalance of the bump plays such a big part. Having said that, there are lots of ways to relieve the pain and to prevent it worsening or occurring.
These home remedies may also reduce PGP/SPD-related discomfort:
placing a pillow between the legs when sleeping
When you’re turning in bed, move your body to one side of the bed to allow room without twisting. With your legs bent up, roll bit by bit, keeping your knees and shoulders pointing in the same direction.
When you get into bed, sit on the bed with your bottom far back, cross your ankles and then lie down on your side. Come up the same way, using your arms to push yourself up.
avoiding sitting for too long
When you’re sitting, use a small cushion or rolled towel in the small of your back, sit right at the back of the chair and place a footstool under your feet to support your legs.
applying an ice/heat pack to the pelvic area
staying active but avoiding any activities that cause pain
incorporating rest breaks every day
wearing supportive shoes (having said that I used any shoes that I could slide on as tying shoes/getting them on and off was soo painful)
keeping the knees together when getting in and out of the car
performing Kegel exercises to strengthen the pelvic floor muscles
Do your shopping online or ask someone to shop for you any lifting pushing and pulling the trolly and uneven weight distribution is not great for SPD.
Avoid breaststroke if you’re swimming and take care with other strokes.
Get dressed sitting down.
The pain can be more intense when walking, opening your legs, going upstairs, and turning over in bed. I remember having to take little dolly steps everywhere, it made me so slow!
When standing, keep your weight even over both feet, try not to push your hips forward or over arch your back.
When you sit down or come up to standing from sitting, keep the weight even on both feet, stick your bottom out and do it in one fluid motion.
Avoid activities that involve asymmetrical positions of the pelvis, such as sitting cross-legged, reaching, pushing or pulling to one side, and bending and twisting to lift or carrying anything on one hip.
Get some help and support, particularly if you have other children. Tasks like hoovering, loading and unloading washing can take their toll, so try and delegate where possible. If you have a clingy toddler, try different ways of comforting, like sitting and getting them to crawl into your lap. If your job is physically demanding, they should be able to make reasonable adjustments for you.
Soft tissue therapy
Soft tissue therapy usually includes chiropractic care, which may involve spinal manipulation and massages to improve pelvic joint stability and positioning.
Wearing a pregnancy support belt
A pregnancy belt supports the pelvic bones and helps maintain correct alignment. The belt may provide short-term pain relief.
A study involving 46 pregnant women with pelvic girdle pain found that the use of a pregnancy support belt reduced pain successfully, but only when the women used it regularly for short periods.
Can I exercise if I have PGP OR SPD?
As well as physiotherapy exercises you should still continue to stay active in any way that does not cause you pain. Your level of activity is likely to depend on the severity of the pain. It can be very frustrating if you were previously active to find that you have to stop or reduce your exercise.
If you can, try different exercises until you find one that works. Some women say that cycling causes no pain while walking is very painful, for others yoga, swimming or aquanatal exercise can provide some comfort. If you are signing up to a yoga or aquanatal class ask the instructor whether they have experience of PGP.
Our Pregnancy yoga classes are safe for you to participate in and are accredited by the royal college of midwives so you can rest assured you are in safe hands.
**When swimming, avoid the breast stroke as this is likely to cause more pain.
One example of a stretch that may provide pain relief is the pelvic tilt. People can perform this exercise by following these steps:
1. Lie down on the back with the knees bent and the feet flat on the floor.
2. Pull the stomach muscles in and tighten the gluteal muscles to flatten the back and tilt the pelvis.
3. Hold the position for 5–10 seconds and then relax.
If this movement relieves discomfort, a person can do 10–20 repetitions.
The key thing to remember is to stop any activity that causes pain!
Slow squeeze pelvic floor exercise
This exercise will help support the organs in your pelvis and your growing baby.
You may not be able to hold this squeeze for long at first, but keep building up the time and make sure you always release it slowly.
Slowly tighten your pelvic floor, lifting the muscles inwards and upwards.
Continue lifting up through your pelvis and into your tummy.
Try to hold it for 4 seconds, then release slowly.
If you find you struggle to hold the squeeze for this long and there’s nothing left to release, try holding it for less time at first and working up to 4 seconds.
Gradually increase the length of the hold. Make sure you always have some of the squeeze left to release and that you’re able to release slowly at the end of the exercise.
Quick squeeze pelvic floor exercises
This exercise will help make you less likely to wet yourself!
Tighten and lift your pelvic floor in one quick contraction, squeezing the muscles inwards and upwards.
Pause before releasing slowly.
Relax fully at the end.
Try to perform each repetition with the same speed and strength as the first.
Remember to breathe normally when you’re doing your pelvic floor exercises.
How often should I do my pelvic floor exercises?
Once you get used to doing them, start off with 5 squeezes 5 times a day. Increase this to 10 squeezes 5 times a day if you can. Try to do a mixture of slow and quick squeezes.
How does PGP or SPD affect labour and birth?
You can ask the physiotherapist and your midwife for help in factoring PGP into your birth plan.
A water birth might be helpful because the water can give you support and allow you to move more easily. You may also find some labour positions better than others and they can advise you on which may be best.
How long does it take for PGP/SPD to go away after birth?
It will depend on the severity of your PGP/SPD, but most women can expect their symptoms to improve 2 to 6 weeks after birth as their hormones and body recover from pregnancy.
This can be frustrating when you have a newborn baby but take the time to rest and accept any help that you are offered. During pregnancy you might like to think about what support you will need after your baby is born and who may be able to help you while you are recovering.
If you’re still in pain when you see your GP for your 6 week check, let them know because they may be able to refer you for physiotherapy.
I hope this information helps and you get relief from pelvic pain this pregnancy.
Donna x
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